Background: Several dermoscopic findings in alopecia areata (AA) are characteristic and aid in the diagnosis of this disease. Studies evaluating the clinical significance of these findings in AA in dark-skinned individuals are sparse. There is no literature of correlation of dermoscopic findings to severity of disease. /// Aims: The aim was to determine the dermoscopic findings of AA in dark skinned individuals and to assess whether certain dermoscopic findings correlate with disease activity and severity. /// Materials and Methods: Totally 116 patients with AA were included in the study. After a thorough clinical history and examination to note type, severity and activity of the disease, dermoscopy was performed using a Heine Delta 20 dermoscope (Heine optotechnik,Herrsching, Germany) and the results were noted in a proforma. Statistical analysis was performed using SPSS13 software using appropriate statistical tools./// Results: Dermoscopic findings were nearly similar to that described in western literature. Yellow dots (YDs) were found to be highly sensitive for diagnosis, increased frequency being seen in Indian prepubertal patients when compared with western literature. YDs/field of vision (FOV) were found more frequently in severe types of AA. There was no correlation of dermoscopic findings to severity of disease. /// Conclusion: Dermoscopic features are similar to that described in the literature. However, YDs are seen in higher frequency. YDs/FOV could serve as dermoscopic criteria to grade severity of AA.
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Sepsis is the commonest cause of neonatal mortality. However the incidence of the latter varies with the geographical area, the socio-economic structure and various customs and practices in the perinatal period. Till date there have been no published data regarding the latter in Nepal. With the neonatal services coming of age in Nepal it becomes pertinent to study the magnitude and characteristics of the burden of neonatal sepsis. We conducted a retrospective study over a period of six years to elucidate the risk factors, clinical spectrum, diagnostic parameters and the outcome of neonatal sepsis at a tertiary care neonatal intensive care unit. In all 265 cases of suspected sepsis were screened using a panel consisting of C - reactive protein, absolute neutrophil count and immature to total neutrophil count ratio and subsequently confirmed by cultures. The cases were early onset (n=44), late onset (n=56) and nosocomial groups (n=40). The data for the intramural (n=32) and extramural (n=68) cases was analyzed separately. In all 265 neonates (male: female = 1.86:1) were screened for sepsis, out of which 183 resulted a positive screen, of which, 100 had pathogenic organisms (37.76%). Prematurity (22 to 71%) was most frequently associated with all the categories: suspect, early onset, late onset, nosocomial, irrespective of whether they were in- or out-born. The major risk factor associated with out-born babies was asepsis during labour (57.4%). Respiratory signs and symptoms were commoner in the in-borns as well as the nosocomials. The commonest complication associated with neonatal sepsis in our study was exaggeration of neonatal jaundice/hepatitis (80 to 92%). The sensitivity and specificity for C - reactive protein, immature to total neutrophil count and absolute neutrophil count were found to be 93% and 49.7%, 36% and 75.6% and 20% and 83.4% respectively. Among the culture positive neonates (n=100), 32 were in-house deliveries, and the rest were out-born. The frequency of early and late-onset sepsis was similar. In all there were 131 isolates from blood, cerebrospinal fluid and urine, out of which 38 (29.0%) were in the in-born babies. Nosocomial sepsis accounted for 44 (33.59 %) of the isolates out of both the in and out-born babies combined. The mortality (10%) and sequelae (7.5%) was higher in the nosocomial sepsis group. We observed that there is a high rate of aseptic home deliveries. Nosocomial sepsis was an important problem in the study though the outcome was not un-encouraging. There is a need for extension and intensification of the maternal and child health services in Nepal.
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Human milk fortifiers (HMF) make up for the nutrient deficit required by preterm, low birth weight neonates. With the availability of a new HMF in India, it was pertinent to test this nutritional advantage in the Indian preterms fed with fortified human milk in terms the bioavailability of the important nutrients. METHODS: Sixty preterm neonates were randomly assigned in two groups of comparable gestational age and weight, the first fed with breast milk fortified with Lactodex fortifier and the second fed with EBM only. The changes in the mean levels of serum total protein and electrolytes (calcium, sodium, potassium (Na+, K+) and phosphorus), and blood urea in the two groups after two weeks were compared using the student's t - test. RESULTS: After two weeks of fortification the mean total serum protein (study group 5.65±0.27 gm/L compared to 5.39±0.25 gm/L in the control group, p<0.001), serum calcium (study group at 9.24±0.32 mg/dl compared to 8.87±0.25 mg/dl in the control group p<0.001), phosphate (5.54±0.18 mg/dl in the study group versus 5.31±0.24 mg/dl in the control group, p<0.001) and Na+, K+ levels were significantly higher than the control group. The fortification was well tolerated. We concluded that using the new fortifier not only provides all the advantages of breast milk but also provides higher amounts of proteins and calcium necessary for sustaining growth and achieving intra-uterine accretion rates in the preterm neonates and is well tolerated.
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The incidence of soil transmitted helminthic infections was assessed among the patients from a rural part of Puducherry, southern coastal region of India. These patients had attended various outpatient departments in our hospital with various gastrointestinal tract complaints and anemia. Total 2600 patients were screened for parasitic infection over a period of one year (2007-2008) by using standard parasitological techniques. Out of these 417 were positive for parasitic infections of which 286 patients had helminthic infections. Males were more infected than the females. The helminths identified were Hookworm (86.36%), Strongyloides stercoralis (6.29%), Ascaris lumbricoides (2.79%), Trichuris trichiura, (1.04%), Enterobius (1.04%) and Hymenolepis (2.44%).
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